摘要
目的探讨螺旋CT三维重建技术在踝关节骨折术前分型和术后评估中的应用价值。方法本研究采用X线摄片和螺旋CT三维重建技术对106例踝关节骨折患者进行术前分型,术后进行复位质量和内固定置入质量的评估。结果术前DR分型与术中所见结果比较,旋前外展型(PAB)、旋前外旋型(PER)、旋后内收型(SAB)、旋后外旋型(SER)的Kappa值为0.76,0.80,0.77,0.75,均≥0.75,一致性较好;术前螺旋CT三维重建与术中所见结果比较,各分型Kappa值为1,0.93,1,0.90,均≥0.90,一致性优秀,CT三维重建分型与术中所见结果的一致性、灵敏度及特异度明显优于DR。术后螺旋CT三维重建对各分型解剖复位检出率以及内固定置入适宜检出率均低于DR(P<0.05)。结论螺旋CT三维重建技术在踝关节骨折的术前分型、术后复位及内固定置入质量评估方面相对于X线摄片检查均具有较大优势,值得临床推广。
Objective To investigate the applied value of three-dimensional reconstruction of multislice spiral CT in the preoperative classification and postoperative evaluation of ankle fractures. Methods This research used X-ray and three- dimensional reconstruction of multislice spiral CT for preoperative classification and postoperative evaluation of the quality of fracture reduction and implant placement for 106 patients with ankle fractures. Results DR preoperative classification results compared with intraoperative findings, the Kappa values of PAB, PER, SAB, SER were 0.76, 0.80, 0.77, 0.75, all≥0.75, good consistency; Preoperative classification of three-dimensional reconstruction of multislice spiral CT com- pared with intraoperative findings, the Kappa values of PAB, PER, SAB, SER were 1, 0.93, 1, 0.90, all≥0.90, excel- lent consistency. The consistency of CT preoperative classification and intraoperative findings, the sensitivity and specifici- ty were far superior to DR. The detection rate of anatomic reduction and implant placement with appropriate using CT three dimensional reconstruction were significantly lower than DR（ P 〈0. 05）. Conclusion Compared with X-ray, the three-dimensional reconstruction of multislice spiral CT has more advantage in the preoperative classification and postoper ative evaluation of ankle fractures, being worth clinical promotion.
出处
《医学影像学杂志》
2015年第12期2220-2224,共5页
Journal of Medical Imaging
基金
新型硅基改性骨修复材料的构建及其生物活性的实验研究(2014年浙江省医药卫生省部培育计划)2014年浙江省医药卫生省部培育计划(2014PYA021)
